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Does the use of an iodine-containing contrast agent to visualise the PICC tip in preterm babies cause hypothyroidism?
Chandra Prakash Rath1, Mary Thomas2, Drew Sullivan3
1Department of Neonatology, King Edward Memorial Hospital, Perth, Western Australia, Australia.
Insights
Iodine-based contrast in preterm neonates did not affect thyroid function tests. However, it improved the certainty of peripherally inserted central catheter (PICC) tip positioning.
Area of Science:
- Neonatal Medicine
- Radiology
- Endocrinology
Background:
- Preterm neonates (<30 weeks) often require peripherally inserted central catheters (PICCs).
- Assessing the safety and efficacy of procedures in this vulnerable population is crucial.
- Iodine-based contrast agents are used in neonates, but their impact on thyroid function requires evaluation.
Purpose of the Study:
- To compare thyroid function tests in preterm neonates exposed to iodine-based contrast with controls.
- To ascertain the certainty of peripherally inserted central catheter (PICC) tip position after contrast administration.
Main Methods:
- A randomized trial involving preterm neonates (<30 weeks) requiring a PICC.
- Infants received either iodine-containing contrast or normal saline.
- Thyroid-stimulating hormone (TSH) levels were measured on day 14 post-PICC insertion and day 28 of life.
Main Results:
- No significant differences in TSH levels were observed between the contrast and control groups at day 14 or day 28.
- PICC tip localization was more certain in the contrast-exposed group (85% vs. 55%).
- Urinary iodine levels were significantly elevated in neonates who received contrast.
Conclusions:
- Iodine-based contrast administration in preterm neonates does not suppress subsequent thyroid function.
- The use of contrast enhances the certainty of peripherally inserted central catheter (PICC) tip visualization.
- This suggests a potential benefit of contrast in improving procedural accuracy without compromising thyroid health.
Aim:
To compare thyroid function tests in preterm neonates (<30 weeks and >48 hour old) exposed to iodine-based contrast with controls and ascertain the certainty of peripherally inserted central catheter (PICC) tip position.
Methods:
Infants requiring a PICC were randomised to receive 0.3 mL of iodine-containing contrast or normal saline. The primary outcome was the difference in thyroid-stimulating hormone (TSH) levels on day 14 post PICC insertion and on day 28 of life.
Results:
41 infants were randomised with no significant differences in TSH level (mIU/L) at day 14 post PICC insertion (3.1 vs 2) or on day 28 of life (2.2 vs 1.7). The PICC tip was more easily localised in the contrast group (85% vs 55%). Urinary iodine levels were significantly increased in the contrast-exposed group.
Conclusion:
Use of contrast did not suppress subsequent thyroid function and helped visualise the PICC tip with more certainty.
Clinical Trial Registration Number:
ACTRN12614000560695, pre-result.
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